بهزاد فیض زاده

Background and Osteoporosis is a bone disease that reduces bone strength and increases the risk of fractures. Evidence suggest an association between nephrolithiasis and osteoporosis and decrease in bone density. The aim of this study was to compare bone densitometry in women with kidney stones and women with no history of stones.
A cross-sectional study was conducted in patients referring to medical centers in Sari, Iran 2015-2016. One hundred and twenty eligible women were compared in the two groups of with and without kidney stones based on demographic characteristics, anthropometric, biochemical, and bone densitometry findings. The groups were compared by t-test for quantitative variables and Chi-square test for qualitative variables in SPSS V19.
The mean of age of participants was 53.64±6.8 years and 77 (64.2%) were postmenopausal. There were 39 women with nephrolithiasis and 38 without kidney stones. Family history of kidney stones and urinary calcium excretion in women with kidney stones were significantly higher than that in those without kidney stones (P = 0.002, P = 0.000). The mean values for bone density in lumbar spine in women with and without kidney stones were 0.851±0.17 and 0.946±0.13 (P=0.001). These values in femoral neck and total hip were 0.815±0.13 and 0.748±0.10 (P=0.003) and 0.891±0.13 and 0.965±0.10 (P=0.001), respectively.
It seems that nephrolithiasis and higher urinary calcium excretion are associated with lower bone mass. Therefore, earlier investigations for osteoporosis are suggested in patients with kidney stones and higher urinary calcium excretion.

At present، although more than 90% of renal stones are treated at a success rate of 68-86% with (ESWL)، complications such as the possible occurrence of hypertension are attributed to application of this technique. The purpose of this study was to determine the correlation of ESWL with the mean arterial blood pressure and heart rate. This analytical study was performed on 75 patients with kidney stones in Mashhad using non-probability and purposeful sampling. Blood pressure was measured at three stages before، during، and after lithotripsy in the supine position. The relationship between ESWL- related hypertension and autonomic neural activity was also evaluated by heart rate spectral analysis. Data was analyzed with t-test and one-way analysis of variance. The mean arterial blood pressure increased from 93. 30±9. 73 to 98. 30±12. 63 in men and from 87. 82±11. 08 to 96. 08±14. 51 mmHg in women during lithotripsy and the difference was found to significant، statistically (P<0. 001). The i ncidence of diastolic pressure ≥ 100 mmHg in patients with diastolic pressure less than 90 mmHg prior to lithotripsy was 7. 5%. These results indicate the risk of hypertension during lithotripsy however، the possible occurrence of hypertension following lithotripsy needs more prospective studies.

Background and Extracorporeal shock wave lithotripsy (ESWL) is initial treatment of choice for most calculi in the kidney. Although ESWL has many side effects one of which is cardiac arrhythmia, occurring mostly in non-synchronized mode. The aim of this research was to determine the effect of extracorporeal shock wave lithotripsy on electrocardiogram changes in patients with renal stone. This quasi-experimental study was carried out on 75 patients with renal stone who were selected by non-probability and convenience sampling. Then electrocardiograph was obtained from participants before, during and after lithotripsy. The relationship between ESWL-associated arrhythmia and autonomic neural activity was evaluated by heart rate spectral analysis. Electrocardiogram changes were interpreted and the data were analyzed in SPSS and SAS using chi-square, independent t-test, paired t-test, McNemar, Cochrane, One-way ANOVA and general linear model. ESWL was found to elicit new or worsened electrocardiogram changes in 66.7 percent patients with no previous cardiac disease. A statistically significant correlation was demonstrated between the presence of ventricular premature contractions and analgesic drugs (p<0.001) and between the presence of ventricular tachycardia and treatment duration (p<0.001). Shock waves delivered by lithotripsy cause cardiac arrhythmia.